1. METHODS The purpose of this paper was to perform a systematic review of the literature and examine the cumulative data addressing rural QOC, in the end being able to make a clear distinction between urban and rural cultures. This should demonstrate to healthcare providers that these differences can play a significant role in the quality of healthcare received. Articles used included those addressing rural adherence to acute myocardial infarction (AMI) and diabetes care treatment guidelines, rural quality of care, and differences in social work and nursing in rural areas. CONCLUSIONS By first understanding the factors that influence QOC measurement in rural communities, we can create a set of standards that is unique to these rural populations and, by doing so, improving the quality of healthcare received as a whole. REFERENCES 1.Baldwin, L.-M.M., Richard F.; Hart, Gary; Beaver, Shelli K.; Every, Nathan; Chan, Leighton, Quality of Care for Acute Myocardial Infarction in Rural and Urban US Hospitals. The Journal of Rural health, 2004. 20(2): p. 99-108. 2.Coon, P.Z., Karen, Adherence to American Diabetes Association Standards of Care by Rural Health Care Providers. Diabetes Care, 2002. 25(12): p. 2224-2229. 3.Crooks, K., Is Rural Nursing a Speciality? Online Journal of Rural Nursing and Health Care, 2004. 4(1): p. 4p. 4.LeSergent, C.M.H., C.J., Rural hospital nurse's stressors and coping strategies: a survey. International Journal of Nursing Studies, 2005. 42(3): p. 315-324. 5.Croxton, T.A.J., Srinika; Mattison, Debra, Social Work Practice Behaviors and Beliefs; Rural-Urban Differences? Advances in Social Work, 2002. 3: p. 117-132. 6.Moscovice, I.R., Roger, Quality-of-Care Challenges for Rural Health. The Journal of Rural health, 2000. 16(2): p. 168-176. 7..Smith, J.H., Richard, Is Rural Medicine a Separate Discipline? Australian Journal of Rural Health, 2004. 12: p. 67-72. Should Different Standards of Quality of Care Exist for Rural and Urban Settings and what Factors Contribute to these Differences? Jennifer Latta, PA-S; David Day, EdS, MPAS, PA-C Department of Physician Assistant \ College of Health Professions, Wichita, Kansas INTRODUCTION Rural and urban locations differ from each other culturally, structurally, economically, and socially. Because healthcare facilities serve the surrounding communities, the structural and cultural make up of these communities plays a large role in health care delivery. However, despite the significant difference between urban and rural communities, quality of healthcare is determined by one set of generalized standards of care. This leaves rural areas at a disadvantage, because they lack many of the elements that urban facilities possess. To better the quality of care (QOC) for rural patients, they need to be recognized as their own entity and specific standards of care developed that address these unique traits. By doing so, rural health care can be recognized for the true specialty that it is instead of a substandard way of practicing medicine. RESULTS Thirty-five articles matched the criteria and were reviewed using evidence-based methods. Close analysis of the presented data found a decrease in the QOC, with regards to AMI and diabetes management, in rural facilites compared to urban. However, the literature also demonstrated many factors that contribute to these QOC differences. Rural areas differ from urban in many ways including: lack of specialty care, smaller size of the community, lack of trasportation, isolation of residents, unique cultural dynamic, interactional community, lack of autonomy, shortage of healthcare providers, and technology deficits. DISCUSSION Sociocultural issues play a large role in rural healthcare. Differences between rural and urban need to be realized and measures taken to account for these distinctions. Many suggestions were made on how to resolve these issues including the use of protocols for infrequently encountered conditions, forming partnerships with urban facilities, community collaboration, utilizing electronic media to decrease isolation, and increase use of home health care. Providers should also take into account the unique characteristics of the rural residents and their perceptions of healthy behavior and local hospitals. Without these needed changes it is possible the QOC guidelines serving rural areas will evolve mainly from the expansion of urban-based care, completely avoiding the individual differences that exist between these two populations. 4. Editorial